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senior medical billing specialist resume example with 8+ years of experience

Jessica
Claire
resumesample@example.com
(555) 432-1000,
, , 100 Montgomery St. 10th Floor
:
Summary

Organized Medical Biller thoroughly versed in medical coding and HIPAA requirements. Personable professional with 10+ years of hands-on experience claiming refunds, reviewing claims and maintaining billing reports.

Accommodating and helpful team player proficient in job-related billing software. Successful Pharmacy Technician bringing 10+ years of experience in filling prescriptions with expert accuracy, building relationships with customers and promoting teamwork within pharmacy settings. Knowledgeable about regulatory guidelines and policies governing fraud, waste and abuse.

Skills
  • HIPAA Compliance Certification
  • Billing and Collection Procedures
  • Chart Auditing
  • Commercial and Private Insurance
  • Medical Terminology
  • Account Reconciliation
  • Verbal and Written Communication
  • Information Confidentiality
  • Records Management
  • Claims Processing
  • Medical Transcription
  • Billing Data Verification
  • Discrepancy Resolution
  • Drug Inventory Control
  • Point of Sale Systems Proficiency
  • Customer Service
  • Detail-Oriented
  • Medication Documentation
  • FDA Compliance
  • Insurance Verification
  • Insurance Billing
  • Account Posting
Education and Training
Liberty University Lynchburg, VA Expected in 05/2016 Bachelor of Science : Interdisciplinary Studies - GPA :

Bachelor of Science in Interdisciplinary Studies with concentrations in Business Administration, Natural Science, Information Management Technology & Criminal Justice

Certifications

National Healthcare Association

  • Certified Billing and Coding Specialist (CBCS) - 2016 to 2018
  • Certified Medical Technologist (MT) - 2016 to 2018
  • Certified Pharmacy Technician (CPhT) - 2016 to 2018
  • Certified Electronic Health Record Specialist (CEHRS) - 2016 to 2018
  • Certified Medical Administrative Assistant (CMAA) - 2016 to 2018
Experience
Northwell Health - Senior Medical Billing Specialist
Bethpage, NY, 11/2017 - Current
  • Utilized various security techniques to maintain confidentiality of client data.
  • Applied HIPAA privacy and security regulations while handling patient information.
  • Communicated with insurance representatives to complete claims processing or resolve problem claims.
  • Contacted insurance providers to verify insurance information and obtain billing authorization.
  • Interpreted medical terminology and pharmacological information to translate information into coding system.
  • Trained new team members on company policies and accounting systems to keep team operations productive and efficient.
  • Collaborated with multi-disciplinary staff to improve overall patient care and response times.
  • Maintained communication and transparency with governing boards, department heads and medical staff.
  • Maintained awareness of government regulations, health insurance changes and financing options.
VA Commonwealth University Health System - Pre-Authorization & Referral Representative
City, STATE, 05/2017 - 11/2017
  • Took billing calls, questions and concerns from patients and third party carriers.
  • Processed claims and forwarded information to Medicare, Medicaid and commercial insurance companies.
  • Entered patient charges and payments into electronic health records.
  • Identified discrepancies and carrier issues regarding billing and reimbursements.
  • Corrected, completed and processed claims for payer codes.
  • Protected medical office operations and integrity by keeping patient information confidential.
  • Oversaw daily collections and accounts receivable activities, developing robust strategies to maximize collections and reduce aged accounts.
  • Answered customer questions to maintain high satisfaction levels.
  • Managed all payments processing, invoicing and collections tasks.
  • Checked claims coding for accuracy with ICD-10 standards.
CVS Pharmacy Health - Pharmacy Technician
City, STATE, 07/2016 - 05/2017
  • Assisted pharmacist with clearing high volume of prescriptions and responded to customer questions.
  • Teamed with peers, technicians and pharmacists to prioritize and complete orders.
  • Created new customer profiles and updated demographics, allergies and new medications in pharmacy computer systems.
  • Maintained pharmacological practices by checking drug inventory, stocking medications and monitoring supplies.
  • Interpreted and processed medication orders under supervision of pharmacist.
  • Received and verified daily incoming drug inventories, reported discrepancies and logged items into inventory system.
  • Liaised with pharmacist to measure and prepare medication doses and packaging and label prescriptions.
  • Transmitted claims to insurance companies for payment and reconciled EOBs.
  • Promoted supplement and nutritional products to maximize sales and customer wellness.
  • Monitored supply inventory and promptly submitted replenishment orders to prevent shortages.
Richmond City Social Services - Program Specialist & Social Worker
City, STATE, 10/2014 - 07/2016
  • Coordinated benefits processing, including enrollments, terminations and claims.
  • Provided assistance to plan participants by explaining benefits information to ensure educated selections.
  • Communicated effectively via email, phone and face-to-face with plan participants to resolve issues pertaining to health and welfare benefits.
  • Mastered state and Federal benefit laws Including ERISA, FMLA, COBRA, HIPPA and 401k administration.
  • Evaluated efficiency and value of current benefit programs and made recommendations for improvement.
  • Assisted with audits by preparing accounts and providing information.
  • Kept operations in compliance with requirements by applying knowledge of applicable regulations, legal statutes and tax code information.
  • Implemented social service interventions to achieve treatment goals and address client needs.
  • Interviewed clients individually and in family groups to determine services to best address specific needs.
  • Referred patients to community resources for mental health treatment, child protective services and assistance for people with developmental disabilities.

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Resume Overview

School Attended

  • Liberty University

Job Titles Held:

  • Senior Medical Billing Specialist
  • Pre-Authorization & Referral Representative
  • Pharmacy Technician
  • Program Specialist & Social Worker

Degrees

  • Bachelor of Science

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